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Painkillers and Bone Mass?
Is it true that painkillers of any kind decrease bone mass if you have osteoporosis? My sister has been told not to take painkillers, but she suffers such bad neck, shoulder, arm, leg, lower back, and knee pain that she cannot even fall asleep at night. If it is true, what else can she do to relieve the pain?
By Dr. Joann Manson, MD, MPH, PhD
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The answer depends on which painkillers your sister is talking about. She may be referring to NSAIDs (nonsteroidal anti-inflammatory drugs), which are given for aches and pains and different forms of arthritis. There's no persuasive evidence that NSAIDs alone increase the chances of osteoporosis, although more studies are needed.
However, other medications called proton pump inhibitors (such as Prilosec) have been linked to osteoporosis and decreased bone mass. These drugs are occasionally given with pain meds like NSAIDs to protect the stomach, and this combo can potentially decrease bone mass. Perhaps this is what your sister is talking about? Similarly, some antidepressant medications have been linked to bone density loss. A bigger concern are medications such as steroids and corticosteroids like prednisone, which can increase the chance of osteoporosis. Taking vitamin A in excess has also been linked to osteoporosis. You would need to get additional information regarding which pain medications your sister is referring to.
In the meantime, there are many pain medications out there that don't cause bone density loss, such as Tylenol with codeine. Your sister should talk with her doctor about the different options. Depending on the medication she's taking, she may be able to counter its adverse effects on bone loss by doing regular resistance exercise and strength training. She should also make sure she's getting enough calcium and vitamin D and avoid excessive alcohol, caffeine, and cola beverages with phosphoric acid, as these may all lead to the leaching of calcium from the bones.
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